Member Protection Provision. This provision supersedes and replaces the Financial Responsibility section (section 3.5 above) only in those cases where UBH, or its Affiliate, is the Payor, or when required by another specific Payor, or when required pursuant to applicable laws, statutes and regulations. In no event, including, but not limited to, non-payment by Payor for MHSA Services rendered to Members by Provider, insolvency of Payor, or breach by UBH of any term or condition of this Agreement, shall Provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against any Member or persons acting on behalf of the Member for MHSA Services eligible for reimbursement under this Agreement; provided, however, that Provider may collect from the Member, any Member Expenses or charges for services that are not covered as benefits under the Member's Benefit Plan. The provisions of this Article shall apply to all Member protection provisions in this Agreement and shall: (a) apply to all MHSA Services rendered while this Agreement is in force; (b) survive the termination of this Agreement regardless of the cause of termination; (c) be construed to be for the benefit of the Members; and (d) except as otherwise stated in section 3.3, supersede any oral or written agreement, existing or subsequently entered into, between Provider and a Member or person acting on a Member's behalf, that requires the Member to pay for such MHSA Services.
Member Protection Provision a. Provider hereby agrees that in no event, including, but not limited to nonpayment by Payor, Xxxxx’s insolvency or breach of this Agreement shall Provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against a Member or person acting on the Member’s behalf, other than Payor, for services provided pursuant to this Agreement. This provision shall not prohibit collection of copayments, co-insurance or deductibles, which have not otherwise been paid by a primary or secondary carrier in accordance with regulatory standards for coordination of benefits, from Members in accordance with the terms of the Member’s Benefit Plan.
b. Provider agrees, in the event of the Payor’s insolvency, to continue to provide the services promised in this Agreement to Members for the duration of the period for which premiums on behalf of the Member were paid or until the Member’s discharge from inpatient facilities, whichever time is greater.
c. Notwithstanding any other provision of the Agreement, nothing in the Agreement shall be construed to modify the rights and benefits contained in the Member’s Benefit Plan.
d. Provider may not bill the Member for Covered Services (except for copayments, coinsurance and deductibles) where UBH or Payor, as applicable, denies payments because Provider has failed to comply with the terms or conditions of this Agreement.
e. Provider further agrees: (i) that the provisions of (a), (b), (c), and (d) of this Section shall survive termination of this Agreement regardless of the cause giving rise to termination and shall be construed to be for the benefit of the Members; and (ii) that this Section supersedes any oral or written or written contrary agreement now existing or hereafter entered into between Provider and Members or persons acting on the Members’ behalf.
f. If Provider contracts with other health care providers who agree to provide Covered Services to Members with the expectation of receiving payment directly or indirectly from Payor, such providers must agree to abide by the provisions of (a), (b), (c), (d), and (e) of this section.
Member Protection Provision. (a) Except for non-Covered Services and services rendered to persons for whom Health Plans is not liable for payment, CompCare agrees and shall cause CompCare Providers to agree that, in no event, including, but not limited to non-payment by Health Plans or Health Plans insolvency or breach of this Agreement, will CompCare or CompCare Providers bxxx, charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any recourse against Members for Covered Services provided pursuant to this Agreement. CompCare shall not, and shall cause CompCare Providers not to, under any circumstances, hold a Member liable for payment of any fees that are the obligation of Health Plans. This provision will not prohibit collection of any applicable copayment/coinsurance/deductible amount billed in accordance with the terms of this Agreement and/or Benefit Plans.
Member Protection Provision. 9.6.1 This Section applies when any applicable Benefit Contract, statute or regulation requires that the Member be held harmless from any and all costs which are the legal obligation of an HMO Subsidiary or the Affiliated Payor.
9.6.2 In no event, including, but not limited to, non-payment for MHSA Services provided to Members; insolvency of an HMO Subsidiary, the Affiliated Payor or, in the case of MHSA Providers, APS; or breath by an HMO Subsidiary of any term or condition of this Agreement or breach by APS of any term or condition of the agreement with the MHSA Provider, shall APS or the MHSA Provider xxxx, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against any Member or persons acting on behalf of the Member for MI-ISA Services eligible for coverage or reimbursement under this Agreement and the applicable Benefit Contract.
9.6.3 The provisions of this Section shall: (a) apply to all MHSA Services provided while this Agreement is in force; (b) with respect to MHSA Services provided while this Agreement is in force, survive the termination of this Agreement regardless of the cause of termination; (c) be construed to be for the benefit of the Members; and (d) supersede any oral or written agreement, existing or subsequently entered into, between an HMO Subsidiary and a Member or person acting on a Member's behalf, that requires the Member to pay for such MI-ISA Services.
Member Protection Provision. In no event, including, but not limited to, non-payment by MTM for Non Emergency Transportation Services rendered for Members by Provider, insolvency of MTM, or breach by MTM of any term or condition of the Agreement, shall Provider xxxx, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against MTM’s Client or any transported Member or persons acting on behalf of Member for Non-Emergency Transportation Services. Provider agrees not to maintain any action at law or in equity against MTM’s Client(s) or any Member to collect sums that are owed to Provider by MTM under the terms of this Agreement even in the event that MTM fails to pay, becomes insolvent or otherwise breaches the terms and conditions of the Agreement.
Member Protection Provision. A. If Payor fails to pay for Covered Services as set forth in the Member’s Benefit Plan, the Member shall not be liable to Provider for any amounts owed by Payor and Provider shall not bill or otherwise attempt to collect from the Member the amount owed by Xxxxx.
X. Xxxxxxx Provider, its agent, trustee or assignee may maintain an action at law against a Member to collect any amounts owed by Payor for which the Member is not liable to the Provider under subsection A of this Section.
C. Nothing in this section impairs the right of Provider to charge, collect from, attempt to collect from or maintain an action at law against a Member for any of the following:
1. Copayment or coinsurance amounts.
2. Health care services not covered by the Payor.
3. Health care services rendered after the termination of this Agreement, unless the health care services were rendered during confinement in an inpatient facility and the confinement began prior to the date of termination, or unless Provider has assumed post- termination treatment obligations under this Agreement.
D. Nothing in this section prohibits a Member from seeking health care services from Provider and accepting financial responsibility for these services.
X. Provider may not charge a Member more than the amount Provider has contracted to charge the Member pursuant to this Agreement.
F. Nothing in this section prohibits any person from informing a Member of either the cost of health care services performed or the status of any bill submitted to UBH in connection with health care services provided to a Member. Any information provided to a Member pursuant to this subsection shall include a statement that the information is not a bill and is for the Member's information only. The statement shall include the following disclosure prominently displayed at the top of the page in all capital letters: "DO NOT PAY THIS STATEMENT. THIS IS NOT A BILL. THE INFORMATION PROVIDED BELOW IS FOR INFORMATION PURPOSES ONLY."
Member Protection Provision. In no event, including, but not limited to, non- payment by Payor of amounts due Provider under this Agreement, insolvency of Payor or any breach of this Agreement by UBH, shall Provider or its assignees or subcontractors have a right to or seek any type of payment from, bill, charge, collect a deposit from, or have any recourse against the Member, the employer or group contract holder for services provided pursuant to this Agreement; except for payment of applicable co-payments or deductibles for Covered MHSA Services not covered by Payor. The requirements of this clause shall survive any termination of this Agreement for services rendered prior to such termination, regardless of the cause of such termination.
Member Protection Provision. In no event, including, but not limited to, nonpayment, insolvency of UBH or Payor, or breach by UBH of this Agreement, shall a Provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against a Member or the Member's designee, other than Payor, for covered benefits provided,
Member Protection Provision. The following shall apply when the Member is covered under Benefit Contract sponsored or issued by a health maintenance organization, including Plan and United HealthCare of Alabama, Inc. - FQ, and in all other instances where required by applicable statutes and regulations: Company hereby agrees that in no event, including, but not limited to, non-payment, insolvency of Payor, or breach of this Agreement, shall Company bill, xxarge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against any Member or persons other than Payor acting on behalf of the Member for Health Services provided pursuant to this Agreement. This provision shall not prohibit collection of Copayments or Deductibles on Payor's behalf, made in accordance with the terms of the Member's Benefit Contract. Company further agrees that (a) this provision shall survive the termination of this Agreement regardless of the cause giving rise to termination and shall be construed to be for the benefit of the Members; and (b) this provision supersedes any oral or written contrary agreement, now existing or thereafter entered into, between Company and a Member or person acting on a Member's behalf. Company may not change, amend or waive any provision of this contract without the prior written consent of Plan. Any attempts to change, amend, or waive this contract are void.
Member Protection Provision. This provision supersedes and replaces Sections 3.3 and 3.4 in all instances where (1) Plan is the Payor, or (2) a specific Payor requires, or any applicable statutes and regulations require that the Member be held harmless from any and all costs which are the legal obligation of the Payor. Corporation shall accept as payment in full for Health Services rendered to Members such amounts as are paid by Payor pursuant to this Agreement. In no event, including, but not limited to, non-payment by Payor for Health Services rendered to Members by Provider, insolvency of Payor, or breach by Plan of any term or condition of this Agreement, shall Corporation or Provider bill, xxarge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against any Member or persons acting on behalf of the Member for Health Services eligible for reimbursement under this Agreement; provided, however, that Provider may collect from Member Copayments, Deductibles or charges for services not covered under the Member's Benefit Contract. The provisions of this Section shall (1) apply to all Health Services rendered while this Agreement is in force; (2) with respect to Health Services rendered while this Agreement is in force, survive the termination of this Agreement regardless of the cause of termination; (3) be construed to be for the benefit of the Members; and (4) supersede any oral or written agreement, existing or subsequently entered into, between Corporation or Provider and a Member or person acting on a Member's behalf, that requires the Member to pay for such Health Services. SECTION 4 HOLD HARMLESS, INDEMNIFICATION, AND LIABILITY INSURANCE
